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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 274416226
Report Date: 08/31/2022
Date Signed: 08/31/2022 12:18:08 PM

Document Has Been Signed on 08/31/2022 12:18 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:DIAZ, AMYFACILITY NUMBER:
274416226
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 6DATE:
08/31/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
09:38 AM
MET WITH:Amy Diaz TIME COMPLETED:
11:20 AM
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Licensing Program Analyst (LPA), Elizabeth Larios, met with Licensee, Amy Diaz, to conduct inspection for capacity increase at Family Child Care Home (FCCH). Upon arrival, there were six children one infant and five toddlers present which is compliant with current home capacity requirements. Hours of operation are Monday-Friday 6:30AM-6:00PM and Saturday 6:30AM-1:00PM.

Licensee states that adults over the age of 18 living in the home are: herself, and fiance (Juan Carlos Munguia) and daughter (Sunshine Crystal Diaz). All adults have criminal record clearances and signed criminal record statements (LIC 508). Licensee also has a minor daughter that resides in the home.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

LPA conducted tour of inside of FCCH during today's inspection and home was observed to be clean, orderly, and safe for the day care children. Off limits areas inside the home are: master bedroom/bathroom, two bedrooms, all kitchen cabinets, and garage. Smoke alarm and carbon monoxide detectors are functioning and FCCH is equipped with 3A40BC fire extinguisher. Fire pull station is installed near the entry way. Fire Clearance for large capacity was conducted and approved on 07/27/2022 by City of Salinas Fire Department. There are conditions for fire clearance approval. There was two play pens. Licensee states she does not plan in admitting more infants at the moment and will purchase play pens if needed in the future. All food is prepared and provided for children by the FCCH.
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Elizabeth Larios
LICENSING EVALUATOR SIGNATURE: DATE: 08/31/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/31/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: DIAZ, AMY
FACILITY NUMBER: 274416226
VISIT DATE: 08/31/2022
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LPA conducted tour of outside of FCCH during todays inspection. Off limit areas outside are: backyard right side of house and yard level upper hill in the backyard.

A file review was conducted for the Licensee daughter that will be assisting Licensee at the home for large capacity. LPA advised Licensee that any staff member/ who will be alone with the children must have current CPR/First-Aid certificates. LPA obtained copy of children's roster (LIC 9040) and reminded Licensee to update roster and paperwork for children prior to enrollment at the home. LPA reviewed capacity and staffing requirements for large family child care home with Licensee and provided copy of regulation. (102416.5 Staffing Ratio and Capacity)

Supervision of children was discussed with the Licensee and she understands that she must be home during day care hours and ensure that children are supervised at all times. The Licensee states that she does transport day care children. LPA reminded Licensee that children should not be left unattended in parked vehicles and that car seats shall only be used for transportation and shall not be used for sleeping.

Exit interview conducted and report was reviewed with the Licensee, Amy Diaz.

As a result of todays inspection, no deficiencies were cited.

A NOTICE OF SITE VISIT WAS GIVEN AND MUST REMAIN POSTED FOR 30 DAYS. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

An exit interview was conducted with Licensee and was informed that upon approval of Licensing Management, a increase capacity for a Large Family Child Care Home will be granted and issued to Licensee.
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Elizabeth Larios
LICENSING EVALUATOR SIGNATURE:

DATE: 08/31/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/31/2022
LIC809 (FAS) - (06/04)
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